Major depression Mental and Behavioural Disorders Depression
Conditions
Interventions
Participants are randomly assigned to receive 12 weekly IPT sessions or 12 weekly sessions of standardized clinical management (CM). Patients are also randomly assigned to receive 20-40 mg per day of
Sponsors
Montreal Heart Institute Research Center (Canada)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Persons of either sex in age groups: 18 years and above. 1. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of current major depressive episode based on the Structured Clinical Interview for Depression (SCID) with at least 4 weeks duration 2. Baseline score greater than 19 on the centralized, telephone-administered 24-item, Hamilton Depression Rating Scale (HAM-D) 3. Evidence of coronary artery disease (CAD) based on hospital chart evidence of a previous hospitalization for acute myocardial infarction, or coronary angiographic evidence of greater than 50% blockage in at least one major coronary artery, or prior revascularization 4. Stable CAD based on physician?s clinical judgement 5. Provision of informed consent
Exclusion criteria
Exclusion criteria: 1. Less than 18 years of age 2. Coronary bypass surgery planned during the next 4 months 3. Canadian Cardiovascular Society Angina Class (CCS) = 4 4. SCID documented bipolar disorder, major depression with psychotic features or evidence of substance abuse or dependency during the previous 12 months 5. Serious suicide or risk based on clinical judgment 6. Use of anti-depressants, lithium or anti-convulsants for mood disorder 7. Currently undergoing any form of psychotherapy 8. Absence of response to a previous adequate trial of citalopram or IPT 9. Two previous unsuccessful trials of treatment for depression for the index episode 10. Lifetime history of early termination (less than 8 weeks) of citalopram because of adverse events or side-effects 11. Lifetime history of early termination (less than 8 weeks) of two other selective serotonin reuptake inhibitor (SSRI) antidepressants (paroxetine, fluoxetine, fluvoxamine, sertraline) because of adverse events or side-effects 12. Significant cognitive problems (Mini-Mental Status Exam [MMSE] less than 24) 13. Depression due to a general medical condition based on clinical judgment 14. Participation in other trials 15. Inability to speak French or English 16. Investigator?s judgment that a patient is unable or unwilling to comply with the study regimen
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The 24-item HAM-D administered centrally by phone at baseline, 6- and 12-weeks. | — |
Secondary
| Measure | Time frame |
|---|---|
| The self-report Beck Depression Inventory (BDI-II) administered at baseline, 6- and 12-weeks. | — |
Countries
Canada
Outcome results
None listed